The patient was the recipient of Robert Schiller's extraordinary knowledge and care. This patient was admitted to the unit following cardiac arrest. He was found face down on the ground unresponsive and pulseless on his farm, an unwitnessed arrest. He was subsequently intubated, resuscitated and brought to our ER. There his head was scanned and hypothermia was initiated. He was extubated in the morning and was essentially alert and oriented. As the day progressed, he began to complain that the right side of his body was not working as well and he felt pins and needles all over his body. The day nurse brought this to the attention of the resident who in turn notified the neurologist. The neurologist assessed the patient and ordered another head CT and an MRI of the brain. The RN during the day took the patient for a head CT the MRI was scheduled to be done later that evening.
At 7pm change of shift occurred; at this time Bob was receiving report from the day nurse. Bob went in and assessed the patient and immediately came out to the night residents to point out that this patient could have potentially fractured his neck, he was found in the field unwitnessed and a collar was never placed. Following Bob's discussion with the residents, a full set of spinal x-rays were then ordered and completed at bedside and an MRI of the neck was added to the MRI of the head. The patient was brought down by Bob to do an MRI of the head and neck.
While Bob was in MRI, he received a phone call from the radiologist reviewing the spinal series done at bedside that C-2 was in fact fractured. Bob completed the MRI and returned upstairs. The diagnosis was determined to be a fracture of C-2 with spinal cord impingement. I truly believe if not for Bob this patient would have gone undiagnosed after multiple physicians had seen the patient and missed ordering the tests necessary. The results could have been irreparable. The patient was then transferred to another unit where a halo was placed and he awaited his neurosurgery.
Bob Schiller is a long time nurse with multiple years of experience in many areas of nursing including many years spent in working in our neuro-ICU. He even still is sometimes called "neuro-Bob" even though he has been with us in CCU for many years now. He is truly proud to be a bedside nurse and enjoys and provides a level of skill and expertise that the nursing profession is always in desperate need of. He has always been an integral part of training of our newer nurses and brings a sense of calm confidence and knowledge to patient care.